2. Your patient has spinal meningitis and it is critical that you retrieve some

Question

2. Your patient has spinal meningitis and it is critical that you retrieve some of their cerebrospinal fluid to assay. Based on your knowl. edge of anatomy describe where you would retrieve this fluid and why. What position would you make your patient assume to most easily retrieve the fluid. Describe, from superficial to deep, all the layers of anatomy that the syringe would have to penetrate to acquire the cerebrospinal fluid. 3. A patient complains of the following symptoms - lack of sweating on the face and decreased visual acuity in darkened settings You quickly get a sense for the possible problem. Describe tests you would perform to pinpoint the exact lesion with the use of your strong anatomy background. 4. While working in the ER a comatose child arrives on your shift. A quick x-ray of the head reveals a small fracture of the cranial ver- tex in the median plane. The anguished parent tells you the child bumped the top of her head but seemed fine until hours later when she became suddenly drowsy. With your strong anatomy background you quickly assess the problem then take immediate measures. Explain probable causes and solutions to this situation.

Explanation / Answer

2). Lumbar puncture (LP) is done to collect the sample of cerebrospinal fluid (CSF) to it analysis. This is done by inserting the needle into the subarachnoid space at the level of L4 or L5. It is also known as a spinal tap. A lumbar puncture can rarely cause a headache because of reduced cerebrospinal fluid. The patient's position must be "the left-side lying fetal position."

The layers crossed by the needle from the superfiical to deep: Epithelial tissue --> superficial fascia- supraspinous ligament --> interspinous ligament- --> epideral space --> dura matter --> arachnoid matter ---> subarachnoid space with (contains the CSF)

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